Individual
GARY KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 KING AVE, CORCORAN, CA 93212-9611
(559) 992-8800
Mailing address
4001 KING AVE, CORCORAN, CA 93212-9611
(559) 992-8800
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 17857
CA
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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